Interventions and strategies to improve social support for caregivers of children with chronic diseases: An umbrella review

Effect of Couple-Based Virtual Intervention on Spousal Support and Quality of Life for Women With Breast and Gynecological Cancers in Nigeria

BACKGROUND

Breast and gynecological cancers contribute significantly to cancer-related mortality among Nigerian women. Despite the proven benefits of spousal support in improving cancer outcomes, male involvement in caregiving remains limited due to cultural norms, stigma, and systemic healthcare challenges.

AIMS

This study evaluated the effectiveness of a couple-based virtual intervention in enhancing spousal support and improving the quality of life (QoL) of women undergoing cancer treatment in Nigeria.

METHODS

An embedded mixed-methods design was employed involving 133 Nigerian couples, where women were receiving treatment for breast or gynecological cancer. The intervention consisted of an 8-week virtual peer support program for male partners, delivered via Zoom. Quantitative data were collected using validated instruments assessing spousal support and QoL, and analyzed using descriptive and inferential statistics. Qualitative data were obtained through semi-structured interviews with 21 male participants and analyzed thematically using NVivo 14.

RESULTS

Post-intervention, significant improvements were recorded in spousal support across emotional (p = 0.0413), practical (p = 0.0296), financial (p = 0.0493), and health-related (p = 0.0313) domains. Women's QoL significantly improved in physical (p = 0.0109), psychological (p = 0.0452), social (p = 0.0024), and spiritual (p = 0.0417) domains. Thematic analysis revealed five key themes: emotional growth and support, understanding of partner's needs, building confidence, value of peer connections, and cultural or logistical barriers.

CONCLUSIONS

The couple-based virtual intervention significantly improved male caregiving engagement and the quality of life of women undergoing cancer treatment. Findings support culturally tailored, gender-sensitive interventions in oncology care within resource-limited settings.

Recommendations to Advance Social Connectedness in End Stage Kidney Disease Care in a Post-COVID-19 Era

Social connectedness, defined as a sense of belonging and inclusion among individuals and groups, is crucial for the well-being of end-stage kidney disease (ESKD) patients. This Perspective employs a hypothetical case study to highlight the risks of social isolation and loneliness faced by ESKD patients. It offers guidance on how the ESKD community can effectively address these challenges. Although in-center hemodialysis provides an inherent environment for fostering social connections, the COVID-19 pandemic has intensified the risk of social disconnection. We delineate 5 key recommendations to mitigate this risk: (1) improve detection of loneliness and social isolation; (2) implement evidence-based social support interventions; (3) revitalize the in-center experience; (4) engage family caregivers; and (5) leverage technology for social connectedness. Neglecting opportunities to bolster social connections among ESKD patients would represent a significant interdisciplinary lapse. The proposed recommendations are feasible due to the integral role of interdisciplinary care within dialysis centers.

Investigation of the relationship between burden of care, social support, and quality of life in parents caring for pediatric dialysis patients

BACKGROUND AND PURPOSE

The objective of our study is to identify the social support requirements of parents caring for pediatric dialysis patients and evaluate how the burden of care impacts caregivers' quality of life.

METHODS

This study employed a descriptive cross-sectional study design. Data were obtained using the "Introductory Information Form," the "Zarit Burden of Caregiving Scale," the "World Health Organization Quality of Life Scale Short Form," and the "Multidimensional Perceived Social Support Scale."

RESULTS

The individuals reported some physical problems after starting caregiving; fatigue level increased and sleep duration reduced by 94.9 %. Participants reported some psychological problems such as increased desire to cry by 93,93.5 %, feeling of distress by 91.6 %, feeling of fear by 86 %. Social problems mentioned as relation with people decreased by 97.7 %, having financial problems reported by 76.7 %. The main burden of care for caregivers was 38.884 ± 14.177, the perceived social support was 49.484 ± 17.923, and the quality of life was 80.349 ± 13.124. A statistically significant negative correlation (r = 0.303, p < 0.05) was found between burden of care and quality of life, positive correlation (r = 0.253) was observed between overall perceived social support and quality of life.

CONCLUSION

Our results confirm that caregivers of pediatric patients have high care burden, low quality of life, and moderate social support.

IMPLICATION FOR PRACTICE

Healthcare professionals should prioritize not only the well-being of patients but also parents, who play a crucial role in providing care at home. If the caregiver is overwhelmed, it is more probable that patients' needs will not be adequately met.

Prevalence of anxiety, depression and post-traumatic stress disorder among the caregivers of children and adolescents diagnosed with cancer in Oman: a multicentre, prospective cohort study

OBJECTIVES

To assess the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) and their associated factors among the caregivers of children diagnosed with cancer in Oman and explore the changes in psychological outcomes over time.

DESIGN

A multicentre, prospective, cohort study.

SETTING

The National Oncology Centre of the Royal Hospital, the Sultan Qaboos University Hospital and the Sultan Qaboos Comprehensive Cancer Care and Research Centre in Muscat, Oman.

PARTICIPANTS

Caregivers of Omani children and adolescents diagnosed with cancer at the three primary cancer referral centres in Oman.

OUTCOME MEASURES

Validated Arabic versions of the State-Trait Anxiety Inventory, the Centre for Epidemiologic Studies Depression Scale and the Impact of Event Scale-Revised were used to screen for symptoms of anxiety, depression and PTSD, respectively. The first assessment (T1) was conducted any time within the first 3 months of the child's diagnosis, while the second assessment (T2) was conducted 3-6 months after T1. Multivariate linear regression models were used to investigate the association between socio-demographic and clinical characteristics and average anxiety, depression and PTSD scores.

RESULTS

Of the 92 caregivers of Omani children and adolescents diagnosed with cancer, 45.7%, 53.3%, 45.7% and 68.5% exhibited state anxiety, trait anxiety, depression and PTSD at T1. Subsequently, prevalence rates of these conditions decreased to 32.6%, 42.4%, 33.7% and 55.4%, respectively, at T2. Between T1 and T2, the prevalence of state anxiety decreased significantly, as did average state anxiety and PTSD scores (p<0.05). According to the univariate analysis, the child's age and awareness of their diagnosis correlated with caregiver depression scores (p<0.05). Moreover, the child's gender was associated with both caregiver anxiety and depression scores (p<0.05). Mothers reported significantly higher depression scores compared with other caregivers (p=0.029). At T2, the type of cancer treatment received by the child was associated with caregiver anxiety and depression scores (p<0.05). At T2, a linear regression analysis showed significant positive associations between state anxiety scores and caregiver education level (β=0.196; p<0.001) and between trait anxiety scores and caregiver gender (β=0.096; p=0.029). Depression scores were significantly negatively affected by the child's age at T1 (β=-0.572; p=0.001) and the child's gender at T2 (β=-0.119; p=0.018). Family income was negatively associated with caregiver PTSD scores at T2 (β=-0.094; p=0.049).

CONCLUSIONS

Caregivers of Omani children and adolescents with cancer, especially mothers, are likely to suffer from anxiety, depression or PTSD. Offering additional psychological support, such as counselling services, to the caregivers of children and adolescents diagnosed with cancer is recommended to reduce psychological distress and address potential mental health challenges in a timely manner.

Caregiver experiences and needs in pediatric rheumatic disease: a mixed-methods systematic review protocol

INTRODUCTION

Understanding the genuine experiences and requirements of caregivers and implementing targeted interventions can have a positive impact on the physical and mental well-being of caregivers with children diagnosed with rheumatic diseases, ultimately reducing their burden and enhancing their quality of life. While there has been a gradual increase in research in this area in recent years, there remains a gap in the evidence that comprehensively and systematically reflects the actual experiences and needs of caregivers. We will employ a mixed-methods approach to evaluate the real-life experiences and requirements of caregivers for children diagnosed with rheumatic diseases to provide insights for both research and clinical interventions. METHODS AND ANALYSIS: All types of studies (quantitative, qualitative, and mixed-methods) involving caregivers of children aged 0 to 18 with rheumatic diseases will be included. We will conduct a comprehensive search across multiple databases, including MEDLINE (PubMed), Embase (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), CNKI, WanFang, and VIP, as well as the grey literature, to identify primary studies published in either English or Chinese since 2000. Two independent reviewers will conduct the selection process and cross-check the data extraction. The focus of interest will be on understanding the experiences and needs of caregivers for pediatric rheumatic disease patients. In our systematic review, we will employ the 2018 version of the Mixed Methods Assessment Tool (MMAT) to evaluate study quality, and we will apply a convergent integration approach to synthesize the data.

ETHICS AND DISSEMINATION

Ethical approval is not needed, as no primary data will be collected. The results will be made available through a peer-reviewed publication.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO 42023465302.

The roles of self-compassion and social support on the maternal adjustment to a child's hip dysplasia

Parenthood can be challenging when facing a child's chronic illness such as developmental dysplasia of the hip (DDH). Although social support is known as a protective factor for the caregiver's mental health, the role of self-compassion is less explored. This study, conducted in Portugal, explored whether self-compassion and social support mediate the relationship between mothers' psychological adjustment and perception of their child's illness. Ninety-four mothers of children with DDH completed questionnaires on illness perception, self-compassion, perceived social support, and psychological distress. Results suggested that self-compassion and social support mediated the relationship between mothers' overall negative perception of the children's illness and psychological distress. The final model accounted for 50% of the variance of depressive symptoms, 40% of anxiety, and 63% of perceived stress. This study highlights the potential value of encouraging mothers to seek social support when facing their child's DDH diagnosis. Promoting self-compassion may be important in clinical intervention.

Perspectives of Caregivers on Access to Health Care for Children with CKD

Introduction

Inequitable access to health care based on demographic factors such as ethnicity, socioeconomic status and geographical location has been consistently found in children with chronic kidney disease (CKD). However, little is known about the perspectives of caregivers on accessing health care. We described caregivers' perspectives on accessing health care for children with CKD from socioeconomically disadvantaged backgrounds and/or rural or remote areas.

Methods

Caregivers of Australian children aged 0 to 16 years, across all CKD stages, from low socioeconomic status backgrounds, and/or residing in rural or remote areas, purposively sampled from 5 centers, participated in semi structured interviews on accessing health care. Transcripts were analyzed thematically.

Results

From 32 interviews, we identified 6 themes: lack of agency undermining ability to seek care (obscurity of symptoms, uncertain and confused about care processes, and vulnerable and unable to advocate), losing trust in clinicians (confused by inconsistencies and ambiguities in advice, and distressed by lack of collaborative care), exasperated by organizational rigidity (frustrated by bureaucratic roadblocks, lack of access to specialist care in rural and remote settings, and inadequacies of support programs), compounding burden of caregiving (unsustainable financial pressure, debilitating exhaustion, and asymmetry of responsibility), intensifying strain on family (uprooting to relocate, sibling stress and neglect, and depending on family support), building resilience and stability (empowerment through education and confidence in technical and medical support).

Conclusions

Caregivers of children with CKD from disadvantaged backgrounds feel disempowered and vulnerable when accessing care for their child. Strategies are needed to improve access to health care for families who are socioeconomically or geographically disadvantaged.

Patient navigator programmes for children and adolescents with chronic diseases

BACKGROUND

Despite a substantial global improvement in infant and child mortality from communicable diseases since the early 1990s there is now a growing burden of chronic disease in children and adolescents worldwide, mimicking the trend seen in the adult population. Chronic diseases in children and adolescents can affect all aspects of their well-being and function with these burdens and their health-related consequences often carried into adulthood. Up to one third of disability-adjusted life years for children and adolescents globally are a result of chronic disease. This has profound implications for the broader family unit, communities, and health systems in which these children and young people reside. Models of chronic care delivery for children and adolescents with chronic disease have traditionally been adapted from adult models. There is a growing recognition that children and adolescents with chronic diseases have a unique set of healthcare needs. Their needs extend beyond disease education and management appropriate to the developmental stage of the child, to encompass psychological well-being for the entire family and a holistic care approach focusing on the social determinants of health. It is for this reason that patient navigators have been proposed as a potential intervention to help fulfil this critical healthcare gap. Patient navigators are trained medical or non-medical personnel (e.g. lay health workers, community health workers, nurses, or people with lived experience) who provide guidance for the patients (and their primary caregivers) as they move through complex (and often bewildering) medical and social systems. The navigator may deliver education, help to co-ordinate patient care, be an advocate for the patient (and their primary caregivers), or combinations of these. Patient navigators can assist people with a chronic illness (especially those who are vulnerable or from a marginalised population, or both) to better understand their diagnoses, treatment options, and available resources. As there is considerable variation in the purpose, design, and target population of patient navigator programmes, there is a need to systematically review and summarise the existing literature on the effectiveness of navigator programmes in children and young adults with chronic disease.

OBJECTIVES

To assess the effectiveness of patient navigator programmes in children and adolescents with chronic diseases.

SEARCH METHODS

We searched the Cochrane Library and Epistemonikos up to 20 January 2023 for related systematic reviews using search terms relevant to this review. We searched CENTRAL, MEDLINE, Embase, CINAHL EBSCO, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal, and ClinicalTrials.gov for primary studies.

SELECTION CRITERIA

We included randomised controlled trials reporting the effect of patient navigator interventions on children and adolescents (aged 18 years or younger) with any chronic disease in hospital or community settings. Two review authors independently assessed the retrieved titles and abstracts, and where necessary, the full text to identify studies that satisfied the inclusion criteria.

DATA COLLECTION AND ANALYSIS

Two review authors extracted data using a standard data extraction form. We used a random-effects model to perform a quantitative synthesis of the data. We used the I² statistic to measure heterogeneity amongst the studies in each analysis. We indicated summary estimates as mean differences (MD), where studies used the same scale, or standardised mean differences (SMD), where studies used different scales, with 95% confidence intervals (CI). We used subgroup and univariate meta-regression to assess reasons for between-study differences. We used the Cochrane RoB 1 tool to assess the methodological quality of the included studies. We used GRADE to assess the certainty of the evidence.

MAIN RESULTS

We included 17 studies (2895 randomised participants). All studies compared patient navigators with standard care. Most studies were at unclear or high risk of bias. Meta-analysis was undertaken only for those studies that had the same duration of patient navigator intervention and follow-up/reporting of outcome measures. The evidence is very uncertain about the effects of patient navigator programmes compared with standard care on self-reported quality of life of children with chronic illness (SMD 0.63, 95% CI -0.20 to 1.47; I2 = 96%; 4 studies, 671 participants; very low-certainty evidence); parent proxy-reported quality of life (SMD 0.09, 95% CI -2.21 to 2.40; I2 = 99%; 2 studies, 309 participants; very low-certainty evidence); or parents' or caregivers' quality of life (SMD -1.98, 95% CI -4.13 to 0.17; I2 = 99%; 3 studies, 757 participants; very low-certainty evidence). It is uncertain whether duration of patient navigator intervention accounts for any of the variances in the changes in quality of life. The evidence is very uncertain about the effects of patient navigator programmes compared with standard care on the number of hospital admissions (MD -0.05, 95% CI -0.34 to 0.23; I2 = 99%; 2 studies, 381 participants; very low-certainty evidence) and the number of presentations to the emergency department (MD 0.06, 95% CI -0.23 to 0.34; I2 = 98%; 2 studies, 381 participants; very low-certainty evidence). Furthermore, it is unclear whether patient navigator programmes reduce the number of missed school days as data were sparse (2 studies, 301 participants). Four studies (629 participants) reported data on resource use. However, given the variation in units of analysis used, meta-analysis was not possible (very low-certainty evidence). All studies reported cost savings or quality-adjusted life year improvement (or both) in the patient navigation arm. No studies reported on adverse events (specifically, abuse of any type against the navigator, the patient, or their family members).

AUTHORS' CONCLUSIONS

There is insufficient evidence at present to support the use of patient navigator programmes for children and adolescents with chronic diseases. The current evidence is based on limited data with very low-certainty evidence. Further studies are likely to significantly change these results.

Examining Emotional and Physical Burden in Informal Saudi Caregivers: Links to Quality of Life and Social Support

BACKGROUND

Caregiver burden is an important issue for individuals who tend to be chronically ill, disabled or elderly family members. This burden affects caregivers around the world and can have a negative impact on their physical and mental health, ultimately reducing their quality of life.

METHODS

This study of informal adult caregivers in Saudi Arabia used a cross-sectional analytic design to explore the connections between caregiver burden, social support and quality of life. Data were collected using nonprobability convenience sampling through electronic questionnaires in Arabic. The Zarit Caregiver Burden Interview (ZBI-12), the Oslo Social Support Scale (OSSS-3) and the SF-12 Health Survey (short form of 12 questions) were used to assess caregiver burden, social support and quality of life, respectively. The relationships between these variables were analysed, and the statistical significance of the findings was reported.

RESULTS

The study revealed a connection between caregiver burden and both social support and quality of life. Caregivers with moderate to high burdens often had poor social support (60.52%) and a lower quality of life (72.47%). A statistically significant negative correlation between caregiver burden and quality of life (p < 0.05) indicated that caregivers with a higher burden had a lower quality of life. Similarly, a statistically significant negative correlation was found between social support and caregiver burden (p < 0.05), suggesting that caregivers with more social support experienced a lower burden.

CONCLUSIONS

A higher caregiver burden is linked to a lower quality of life, especially when social support is inadequate. These findings highlight the need for targeted interventions to reduce caregiver burden by enhancing social support systems for caregivers and improving their quality of life. Recommendations include the development of community-based support programmes and policy changes to support informal caregivers.

Exploring Stress and Coping in Caregivers of Children with Pulmonary Vein Stenosis: A Mixed-Method Study

(1) Background: This mixed-method study aims to identify and describe factors associated with acute and long-term parenting stressors and coping strategies in caregivers of children with intraluminal pulmonary vein stenosis (PVS). (2) Methods: Parents of children with severe PVS were recruited from a large quaternary hospital to complete a survey that included demographics, the Pediatric Inventory for Parents (PIP), and the Coping Health Inventory for Parents (CHIP). We determined the Social Vulnerability Index (SVI) based on self-reported home address. A subset of caregivers completed a 60 min semi-structured interview via Zoom exploring the impact their child's diagnosis had on their family; experience managing stress in the hospital and at home; current resources and processes for coping; and potential recommendations for hospitals to build resilience and coping. We used multivariable linear regression to examine the association between SVI and parental stress and coping while adjusting for possible confounders. Thematic analysis identified themes related to stress and coping. Finally, we assessed instances of convergence and difference between the qualitative and quantitative results. (3) Results: Participants included 32 caregivers who were 91% female with a mean age of 39 years. The children of participants were 66% female, with a mean age of five years. The parents reported a high amount of stress with an average PIP score of 120, nearly 46 points higher than similar studies in the congenital heart community. We observed no significant associations between SVI and either parental stress or coping in adjusted models. We identified 13 themes, including medical care, hospital, family, support systems, and home medical routine or support. (4) Conclusions: Our study found high levels of illness-related parental stress among caregivers of children with PVS. Stress evolved over time from what caregivers described as 'survival mode' to a future-oriented outlook. Currently, caregivers rely heavily on support networks that are not available to all caregivers or may experience strain over time. Caregivers indicated that communication and parental role functioning were coping strategies that could be better supported by providers and health systems.

Ecosystem Barriers and Facilitators Linked to the Fear of Cancer Recurrence: An Umbrella Review

The fear of cancer recurrence is an important topic in the healthcare field. In general, approximately 40% of survivors experience high levels of fear of recurrence. This study aims to fill this gap by synthesizing the findings of systematic reviews studies investigating ecosystems, correlates or predictors, and barriers and facilitators of fear of cancer recurrence among cancer survivors. An umbrella meta-synthesis was conducted using the following databases: MEDLINE, PsycINFO, PsycARTICLES, CINAHL, Business source premier, and SOCindex, ending in April 2024 with PRISMA methods. A total of 24 systematic reviews, representing 729 articles, were included in the study. In total, six ecosystems were identified, including family, work, friends, the healthcare system, caregivers, and religion. As part of this umbrella review, 55 specific ecosystemic factors were identified that may contribute to fear of cancer recurrence. Furthermore, the umbrella review identified 12 facilitators and 12 barriers related to fear of cancer recurrence. This umbrella meta-synthesis contributed significantly to our review's strength in synthesizing the main ecosystem and its influence on fears of cancer recurrence. Understanding the interdependence of ecosystems should enable future research on intervention effectiveness or the development of interventions that could reduce the fear of cancer recurrence.

Effect of family-centered care interventions on well-being of caregivers of children with cerebral palsy: a systematic review

Background

Caring for a child with long-term functional limitations can have a negative impact on the physical and psychological well-being of the caregiver. Family-centered care (FCC) interventions have the potential to empower caregivers and contribute to their well-being. This systematic review aimed to synthesize existing evidence on the effectiveness of FCC interventions in improving the well-being of caregivers of children with cerebral palsy (CP), and identify the key components of such interventions that are most commonly practiced and deemed effective.

Methods

This review systematically searched seven databases for randomized controlled trials that evaluated the effectiveness of any FCC intervention on the well-being of caregivers of children with or at risk of CP. We used the Cochrane RoB 2.0 tool to assess risk of bias and Critical Appraisal Skills Programme (CASP) checklist for critical appraisal. Due to high heterogeneity of studies, narrative synthesis was used to summarize the data.

Results

The review consists of 11 studies which were categorized into five sections based on the components of FCC intervention provided in each individual study: 1. Information provision, and Enabling and partnership (n= 5); 2. Information provision, and Respectful and supportive care (n= 1); 3. Enabling and partnership (n= 2); 4. Enabling and partnership, and Respectful and supportive care (n= 2); 5. Information provision, Enabling and partnership and Respectful and supportive care (n= 1). Risk of bias was low in four studies, unclear in two studies, and high in five studies.

Conclusion

FCC interventions were found to be effective in improving caregivers' satisfaction with attainment of child and caregiver goals. Evidence from multiple studies does not strongly support the effectiveness of FCC interventions on caregiver's mental health, parenting and personal outcomes. Limited evidence precludes a conclusion on the effectiveness of the components of FCC on well-being of caregivers of children with CP.

Interventions to address parenting stress among caregivers of children with chronic diseases: An umbrella review

BACKGROUND

Caregivers of children with chronic diseases suffer from great parenting pressure, which directly affects the treatment and rehabilitation of children, reduces the quality of life of caregivers and damages family functioning. Existing reviews have not systematically summarized and evaluated interventions for parenting stress in caregivers of children with chronic diseases.

DATA SOURCES

Embase, PubMed, Web of Science, OVID, CNKI, CBM, Wan Fang and Cochrane Library were searched for eligible reviews in November 2021 and October 2022.

METHODS

Two reviewers independently screened titles and abstracts, reviewed full texts of articles for eligibility, and appraised the quality of reviews using JBI. The quality of the evidence was assessed using GRADE. Findings are reported in accordance with PRISMA checklist. Narrative summaries grouped findings by intervention types.

RESULTS

Out of 2632 records, we included 21 systematic reviews for a synthesis. Interventions for parenting stress in children with chronic diseases were divided into seven categories. Cognitive behavioural interventions, psychosocial interventions, child behavioural and/or developmental parent interventions and synthesized interventions have shown high-level evidence in reducing parenting stress for caregivers of children with chronic diseases. Furthermore, outcome measures and intervention protocols were highly heterogeneous across interventions.

CONCLUSIONS

This umbrella review suggest that reducing the parenting stress of caregivers of children with chronic diseases can directly target caregivers' parenting stress through cognitive behavioural interventions/psychosocial interventions and/or provide guidance to parents on the behavioural and developmental problems of children with chronic diseases. A more standardized approach to outcome measures is essential to assess efficacy and compare interventions across studies.

RELEVANCE TO CLINICAL PRACTICE

The findings provide information and evidence for reducing parenting stress among caregivers of children with chronic diseases to guide the development of comprehensive intervention strategies.

PATIENT OR PUBLIC CONTRIBUTION

Patient or public contribution does not apply to this study.

Impact of Inflammatory Bowel Disease on Patients' Caregivers: Results From a French Survey

BACKGROUND

The impact of inflammatory bowel disease (IBD) on caregivers has rarely been investigated. Our work aims to explore the burden of IBD on the different aspects of caregivers' lives.

METHODS

We conducted an online survey via the social network of the French IBD patient organization addressed to patients' caregivers who were asked to fill in a questionnaire covering the impact of the disease on different aspects of their lives. Impacts were measured by a visual analog scale (VAS). A VAS score ≥5 of 10 was considered significantly high. We then performed uni- and multivariate analyses of predictors of higher impact on parents and partners, separately.

RESULTS

A total of 853 caregivers participated, predominantly women (77%). The mean age was 48.5 years. Their relationship with the patient was mainly parents in 57.1% and partners in 30.6%. The type of IBD was Crohn's disease in 63% and ulcerative colitis in 35%. The psychological burden was the highest among parents and was mainly correlated with a lack of knowledge about IBD and professional compromise (P < .05). The impact on leisure was the highest among partners and was affected by psychological, sexual, and professional burdens (P < .05). About 50% of partners experienced an absent sexual relationship for weeks/months and decreased libido regardless of IBD type. Professional impact was greater in parents compared with partners, and 36% of caregivers needed work arrangements.

CONCLUSIONS

IBD has a high impact on different aspects of life of patients' caregivers. Therefore, interventions to reduce the disease burden in this population are needed.

Disparities in Patient Family Social Determinants of Health in a Large Urban Pediatric Health System

INTRODUCTION

This analysis sought to identify disparities in social determinants of health (SDOH) outcomes at a Texas pediatric hospital.

METHODS

This retrospective study used electronic health records of pediatric patients families surveyed August -December 2022. Outcomes for health literacy, social support, food, transportation, energy, digital, and housing insecurity, and tobacco exposure were analyzed across demographic categories.

RESULTS

Among 15,294 respondents to the survey (mean child age, 8.73 years; 43.68% Hispanic, 29.73% non-Hispanic White, 18.27% non-Hispanic Black, 6.79% other race/ethnicity; 53.95% male), 50.25% of respondents reported at least one SDOH, whereas 23.39% reported two or more SDOH. The most prevalent SDOH was lack of social support (3,456, 23.91%). Hispanic, non-Hispanic Black, and other race/ethnicity respondents, non-English speakers, and public insurance users had higher odds of reporting almost all SDOH in logistic regression models adjusted for age, race/ethnicity, language, gender, and insurance type.

DISCUSSION

Race/ethnicity, language, and insurance type disparities were identified for all SDOH.

Lived Experience of Parents with Technology-Dependent Children: A Phenomenological Study

Caring for technology-dependent children significantly impacts the family unit, a topic that has not been researched in Portugal. Understanding this impact can help nurses to improve their interventions. This study aimed to describe the lived experiences of parents with technology-dependent children using a qualitative descriptive design. We applied Giorgi's approach to analyze 10 individual semi-structured interviews with parents recruited through a children's hospital in Portugal. Our analysis identified two major themes: (1) Discovering a new parenthood: parent and caregiver, comprising two subthemes: Family reorganization and Learning to use a medical device; (2) Reconciling daily life with the needs of the technology-dependent children, comprising two subthemes: Importance of support systems and Experiencing difficulties. These results indicate that parents experience a wide range of concerns and challenges in managing medical devices, starting from the moment the need for a device is communicated and continuing through the process of learning and providing care. This journey involves significant changes in family dynamics and is marked by sacrifice and adaptation, supported by family, formal support systems, and healthcare professionals. Our findings provide valuable insights into the vulnerabilities faced by these parents and highlight how nursing care can enhance the quality of care for these families.

Family management experience of parents of children with chronic heart failure: A qualitative study

PURPOSE

To explore the experience of family management among parents of children with chronic heart failure.

DESIGN AND METHODS

Qualitative descriptive phenomenology was used as the research design. The sample included 16 parents. For data collection, semi-structured interviews were conducted. Colaizzi's seven-step analysis method was used for data analysis. Themes were encoded and created with Nvivo 12.0 Plus software.

RESULTS

Three themes and ten sub-themes were identified: (1) weakened family socialization (diminished parental role in social education and insufficient socialization of children), (2) experience of five psychological stages (resistance, self-blame, worry, exhaustion, acceptance), and (3) family management dilemmas (low social awareness of the disease, heavy economic burden, and limited coping style).

CONCLUSION

The experience of parents of children with chronic heart failure is complex. The children have low socialization and face public prejudice. Parents are stressed by social education, economics, and the five psychological stages they have experienced. Families face difficulties such as heavy economic burdens and limited coping styles.

PRACTICE IMPLICATIONS

To address these complexities, pediatric nursing staff should take steps to improve family management and, as a result, children's quality of life. Our study provides a resource for pediatric nursing staff when implementing family management interventions.